Stiffness After Total Knee Arthroplasty A Review

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Rheumatology

Background:

• Postoperative stiffness is a significant complication following primary total knee arthroplasty.
• High prevalence of arthrofibrosis leads to poor patient outcomes, revision surgeries, and increased healthcare costs.
• Patient-specific, intraoperative, and postoperative factors contribute to the development of arthrofibrosis.

Purpose of the Study:

• To review the challenges and contributing factors of postoperative stiffness in total knee arthroplasty.
• To discuss current treatment strategies for arthrofibrosis.
• To highlight the direction of future research in managing knee stiffness.

Main Methods:

• Literature review of studies on postoperative stiffness and arthrofibrosis after total knee arthroplasty.
• Analysis of predisposing factors, treatment outcomes, and emerging therapeutic targets.
• Synthesis of current understanding of the pathological cascade of arthrofibrosis.

Main Results:

• Arthrofibrosis affects a substantial number of patients, often necessitating revision surgery with diminished success rates.
• Early intervention with manipulation under anesthesia (MUA) and lysis of adhesions can be effective.
• Patients unresponsive to conservative management often require revision surgery, which carries a higher risk of poorer outcomes.

Conclusions:

• Postoperative stiffness remains a critical issue in total knee arthroplasty, impacting patient function and healthcare resources.
• While MUA is a viable early treatment, persistent stiffness may necessitate complex revision procedures.
• Ongoing research into the pathophysiology of arthrofibrosis and development of targeted therapies are crucial for improving patient outcomes.